ABSTRACT
Dissociation of the polyethylene liner from its metal shell has been reported as a rare occurrence. During a 4-year period, six hips in five patients who had the Harris-Galante II porous acetabular component implanted as part of a primary or revision total hip arthroplasty presented with acute onset of pain and difficulty ambulating more than 2 years after surgery (range, 27-103 months). Radiographic evaluation revealed an eccentrically placed femoral head within the acetabular component. In patients whose acetabular shells were well-fixed, a polyethylene liner was cemented into the acetabular shell (four hips in three patients), and in one patient (one hip), the acetabular component was revised because of fracture of the metal shell. One patient who had a radiographically well-fixed component refused surgery (one hip). During a 4-year period, from 1990 to 1994, this implant was used resulting in a 2.6% incidence of dissociation. This case series is the largest of this complication for one prosthetic design.
Subject(s)
Hip Prosthesis/adverse effects , Polyethylene/chemistry , Prosthesis Failure , Adult , Aged , Biocompatible Materials , Female , Hip Joint/diagnostic imaging , Humans , Male , Metals , Middle Aged , Polyethylene/adverse effects , Prognosis , Prosthesis Design , Radiography , Reoperation , Retrospective StudiesABSTRACT
Skeletal infection involving Torulopsis glabrata is extremely rare. A 66-year-old woman developed Torulopsis glabrata osteomyelitis during a course of prolonged antibiotic therapy for staphylococcal pneumonia that occurred as a postoperative complication of a total knee arthroplasty for osteoarthritis. Roentgenograms and a biopsy sample revealed a destructive inflammatory lesion of the vertebrae. The presence of the yeast organism in the lesion was demonstrated definitively by culture and tissue pathology, removing any doubt about the pathogenicity of the organism. The disease was successfully treated with 5-fluorocytosine, and the patient recovered without functional impairments.
Subject(s)
Candidiasis , Knee Prosthesis , Osteomyelitis/diagnosis , Postoperative Complications/diagnosis , Spondylitis/diagnosis , Aged , Candida/isolation & purification , Candidiasis/microbiology , Female , Humans , Lumbar Vertebrae , Osteomyelitis/microbiology , Spondylitis/microbiologySubject(s)
Knee Injuries/diagnostic imaging , Knee Joint/diagnostic imaging , Sulfur , Synovial Cyst/diagnostic imaging , Technetium , Adolescent , Adult , Child , Female , Hip Joint/diagnostic imaging , Hip Prosthesis , Humans , Knee Prosthesis , Male , Middle Aged , Radiography , Radionuclide Imaging , Technetium Tc 99m Sulfur ColloidABSTRACT
Total hip or knee replacement in elderly patients may be advisable to relieve pain, improve joint motion, and increase the overall function. Indications for hip and knee arthroplasty are outlined and possible complications are addressed. Excellent results using both techniques have been reported in the elderly.
